Public engagement on potential changes to NHS prescriptions for gluten-free bread and flour mixes in Dorset

Survey open 17 July 2025 – 20 August 2025

The proposed changes

Currently in Dorset, people with a diagnosis of either coeliac disease or dermatitis herpetiformis can receive an NHS prescription for gluten-free bread or flour mixes, subject to normal NHS prescription charge rules. In line with other health regions in England, NHS Dorset is considering changing this, meaning that people would no longer be able to obtain these items on an NHS prescription.

Why gluten-free food is needed for people with coeliac disease and dermatitis herpetiformis

These are chronic inflammatory autoimmune diseases of the digestive system and skin caused by a reaction to gluten; a protein found in wheat, barley, and rye. There is no cure for these conditions, but following a gluten-free diet helps control symptoms and prevent long-term complications. More information is available on the NHS website.

Why are NHS Dorset considering changes to prescription availability

To provide high quality medical care for as many people as possible, the NHS is constantly looking for ways to work differently, to ensure the best use of available NHS finances. NHS Dorset believes that this change will allow the better allocation of resources to meet the needs of the wider Dorset population and free up time, currently required for the generation of these prescriptions, for healthcare staff to provide other services. With a wide selection of gluten free products available for purchase they are no longer considered to be specialist; therefore, do not need to be issued on a NHS prescription, giving people freedom of choice.

Other points taken into consideration include:

  • Increased availability: historically, gluten-free products were considered to be specialist products and were only available on prescription. In recent years, a increase in the range of gluten-free foods in supermarkets and online retailers has improved patient choice and made it possible to eat both a healthy and varied gluten-free diet.

  • Access: 75% of Dorset patients with coeliac disease and dermatitis herpetiformis already self-purchase bread and flour mixes.

  • Greater awareness: public awareness of coeliac disease and gluten intolerance has significantly increased demand which has helped to improve access to a wider range of gluten-free options in shops. It is also possible to eat a gluten-free diet without the need for specialist dietary foods. People can also choose naturally gluten-free carbohydrate-foods, such as rice and potatoes, as part of a healthy balanced diet.

  • Improved labelling: clearer food labelling makes it easier for individuals to identify gluten-free products.

  • Cost considerations: the cost of gluten-free bread and flour mixes available on prescription is significantly higher than those available in supermarkets and online. In addition to the cost of the prescription products themselves, the NHS pays the cost of processing the prescription items. This makes the price of gluten-free foods on an NHS prescription up to 4 times higher than buying it directly from a supermarket or online supplier. This change would also free up health care staff time to provide other clinical services.

We would very much appreciate your thoughts on this topic.

Please complete the survey by 20 August 2025.

Responses to this survey will be received by NHS Dorset Integrated Care Board and will be kept confidential under the Data Protection Act 2018.

If you have any concerns or questions:

Please contact NHS Dorset using the customer care email: customer.careteam@nhsdorset.nhs.uk